Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2020-07-26
- Stop
- 2020-07-26
The parties
- Patient
- patient Chi Frederic Corwin
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
1b01d5b1-f332-7aa1-a34d-a70219e77a76