Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2014-07-15
- Stop
- 2014-07-17
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-4262-88b5015ab2d5