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Visit

Emergency room admission

One dated clinical visit by one patient.

Neighborhood Provenance
Claim total
$949.77
base $127.17 · payer covered $0.00

The visit

Class
Emergency
Code
50849002
Reason
diagnosis concept Traumatic dislocation of temporomandibular joint81629009
Start
2021-10-12
Stop
2021-10-12

The parties

Patient
patient Grant Earl Fay
Provider
provider Valeria Hoeger
Care site
care site PROVIDENCE PLACE
Payer
payer Humana
Record id 1db3f28a-a567-c10e-3589-e750cff418d4