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
- 2014-06-07
- Stop
- 2014-06-08
The parties
- Patient
- patient Kristofer Jordan Bruen
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Anthem
Record id
2aad9e33-b123-2099-0127-214b31d53c46