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
- 2011-08-20
- Stop
- 2011-08-20
The parties
- Patient
- patient Carolynn Georgeann Lesch
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Medicare
Record id
155337b4-7ad2-87d7-37eb-110e555d8df1