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  • Service Place and Dates: My Health Information My Health Information

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    Jazmine C
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    The client had an outpatient claim for $680.73 at Memorial Hermann Memorial Hospital in Houston, Texas from February 7th to February 7th, 2022. They were diagnosed with a contusion of the left upper arm and nicotine dependence from cigarettes. X-rays were taken of the shoulder and elbow and the client had an emergency department visit.

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    23180830

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    The client had an outpatient claim for $680.73 at Memorial Hermann Memorial Hospital in Houston, Texas from February 7th to February 7th, 2022. They were diagnosed with a contusion of the left upper arm and nicotine dependence from cigarettes. X-rays were taken of the shoulder and elbow and the client had an emergency department visit.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    9 views2 pages

    Service Place and Dates: My Health Information My Health Information

    Uploaded by

    Jazmine C
    The client had an outpatient claim for $680.73 at Memorial Hermann Memorial Hospital in Houston, Texas from February 7th to February 7th, 2022. They were diagnosed with a contusion of the left upper arm and nicotine dependence from cigarettes. X-rays were taken of the shoulder and elbow and the client had an emergency department visit.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    My Health Information

    This section provides you with an overview of the Health Events for the client you selected

    Service Place and Dates


    CCll ai
    aimm Ty
    Typp e :: Outpatient

    Pa
    Paiid
    d Am
    A moou
    unntt : $680.73

    From Date:
    D ate: 02/07/2022

    To
    To D ate
    ate:: 02/07/2022

    PProv
    roviide
    d er N ame
    am e:: MEMORIAL HERMANN MEMORIAL HOSPITAL SYSTE

    Provi
    P roviddeer AAd
    d d re ss
    ss:: 1635 NORTH LOOP WEST, HOUSTON, TX 77008

    Diagnoses
    Diagnosis Code Description
    S40022A CONTUSION OF LEFT UPPER ARM, INITIAL ENCOUNTER

    F17210 NICOTINE DEPENDENCE, CIGARETTES, UNCOMPLICATED

    Procedures
    Procedure Description From Date To Date Provider Name
    Code
    02/07/2022 02/07/2022 BANSAL SONIA
    73030 X-ray of shoulder, minimum of 2 views 02/07/2022 02/07/2022 BANSAL SONIA

    73080 X-ray of elbow, minimum of 3 views 02/07/2022 02/07/2022 BANSAL SONIA


    99284 Emergency department visit, problem … 02/07/2022 02/07/2022 BANSAL SONIA
    :
    :

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