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
- 2017-09-19
- Stop
- 2017-09-19
The parties
- Patient
- patient Eduardo Daniel Bueno
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Aetna
Record id
21685970-efe4-1907-d23d-b6be99dc4ed8