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
- 2022-09-15
- Stop
- 2022-09-15
The parties
- Patient
- patient Violeta Mandi Schaefer
- Provider
- provider Allan Rowe
- Payer
- payer Medicare
Record id
124c1515-c98a-6eca-32fa-b5ab3c2d9fc6