Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-10-01
- Stop
- 2025-10-01
The parties
- Patient
- patient Charles Victor Borer
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
0e9d79c1-9e6a-9453-8c96-36a9eba14a8f