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
- 2016-10-29
- Stop
- 2016-10-29
The parties
- Patient
- patient Mary Anibal Weissnat
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
2db43a26-232a-1c26-6118-e994a523c1a4