Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2023-06-29
- Stop
- 2023-06-29
The parties
- Patient
- patient Elinore Lizeth Crist
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Aetna
Record id
1c47d02d-0fef-9635-faeb-c9c9a0d73a76