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
- 2017-02-16
- Stop
- 2017-02-16
The parties
- Patient
- patient Brandon Clint Pacocha
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Medicaid
Record id
2d097868-35ff-1c12-7213-4752a79c17d4