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
- 2020-06-22
- Stop
- 2020-06-22
The parties
- Patient
- patient Edwin Laverne Dicki
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer No insurance
Record id
273c3f5e-5294-cd58-bb22-066929d754ad