Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2004-10-07
- Stop
- 2004-10-07
The parties
- Patient
- patient Sumiko Bethann Baumbach
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
23c570a1-24f2-7527-feb1-0697b5be2414