Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2018-03-21
- Stop
- 2018-03-21
The parties
- Patient
- patient Claudette Arlean Thiel
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
39946394-5083-4083-524e-c5446d324cc2