Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Concussion with no loss of consciousness62106007
- Start
- 1980-05-08
- Stop
- 1980-05-08
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-b591-3075bdf2e808