Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-07-21
- Stop
- 2023-07-21
The parties
- Patient
- patient Dwain Lubowitz
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer UnitedHealthcare
Record id
161a011f-815c-6571-4225-6c9ae6d25520