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
- 2021-06-27
- Stop
- 2021-06-27
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-e154-586e9122470c