Claim total
$538.47
base $127.17 · payer covered $488.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2021-05-15
- Stop
- 2021-05-15
The parties
- Patient
- patient Javier Gregorio Mares
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
2d487497-28fb-9da5-6e46-48067847eb01