Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2017-10-10
- Stop
- 2017-10-10
The parties
- Patient
- patient Jefferson Renaldo Dach
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer UnitedHealthcare
Record id
17cb5ccc-4c1f-9747-811c-00d8a30b46d8