Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 183478001
- Reason
- diagnosis concept Asthma195967001
- Start
- 2025-07-07
- Stop
- 2025-07-07
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-f6ed-6e3f6761baf5