Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2016-09-24
- Stop
- 2016-09-24
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-c79e-ef8681067fc3