Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2017-11-14
- Stop
- 2017-11-14
The parties
- Patient
- patient Antonia Palacios
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Anthem
Record id
3695eacd-d76f-1a40-7988-8865c56c3cfe