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
- 2017-06-09
- Stop
- 2017-06-09
The parties
- Patient
- patient Ezra Byron Schaden
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
34aa3e64-c42a-515e-16e4-7a1456005bf4