Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2016-11-30
- Stop
- 2016-11-30
The parties
- Patient
- patient Abraham Sal Schroeder
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
1e00f4b9-9e28-52cb-6e0e-a6a5a8328267