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
- 2024-08-07
- Stop
- 2024-08-07
The parties
- Patient
- patient Raquel Jacque Hammes
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Anthem
Record id
27cca774-3306-e72e-b746-fa2d3395aaca