Claim total
$127.17
base $127.17 · payer covered $127.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2024-12-27
- Stop
- 2024-12-27
The parties
- Patient
- patient Merideth Sabrina Wyman
- Provider
- provider Emmanuel Champlin
- Care site
- care site CREST VIEW HOME HEALTH CARE
- Payer
- payer Cigna Health
Record id
1bb67376-9296-102b-ae9e-13963c73d7c0