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
- 2016-03-11
- Stop
- 2016-03-11
The parties
- Patient
- patient Jake Jeremy Osinski
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicare
Record id
0dfbe012-8ee8-d7ad-be3a-989f64a0dd4c