Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2017-05-08
- Stop
- 2017-05-08
The parties
- Patient
- patient Kendra West
- Provider
- provider Juli Predovic
- Care site
- care site KINDRED AT HOME
- Payer
- payer Medicare
Record id
3a2978f5-5447-2483-a8ce-ed135878a51b