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
- 2023-11-06
- Stop
- 2023-11-06
The parties
- Patient
- patient Matilde Olene Harvey
- Provider
- provider Allan Rowe
- Payer
- payer Humana
Record id
33a98c52-0030-f7ee-aea8-735c265f44af