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
- 2020-05-09
- Stop
- 2020-05-10
The parties
- Patient
- patient Jone Rae Hilpert
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicare
Record id
06668488-9bc5-0bda-08b7-bc331e8c27e5