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
- 2022-12-16
- Stop
- 2022-12-16
The parties
- Patient
- patient Pamula Ellan Kiehn
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
3a501eb2-e422-6d85-d9b0-de17e8e5f20a