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
- 2018-01-18
- Stop
- 2018-01-18
The parties
- Patient
- patient Micaela Canales
- Provider
- provider Elisabeth Smith
- Payer
- payer Humana
Record id
2386688b-63a6-390b-b440-835be74c06ca