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
- 2018-02-19
- Stop
- 2018-02-19
The parties
- Patient
- patient Howard Thanh Treutel
- Provider
- provider Evalyn Torphy
- Care site
- care site ALLIANCE HHC & NURSING SERVICE
- Payer
- payer UnitedHealthcare
Record id
0f92d8ab-2a11-4a72-dd26-e06600ea69d1