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
- 2024-09-12
- Stop
- 2024-09-12
The parties
- Patient
- patient Starr Chun Hackett
- Provider
- provider Claudia Bauch
- Care site
- care site THE VILLA AT ST LOUIS PARK
- Payer
- payer Medicaid
Record id
2eeb7532-520e-d315-33f7-8d24b101043d