Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-05-03
- Stop
- 2025-05-03
The parties
- Patient
- patient Wilfred Jeromy Nolan
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
339a5997-d469-f9bc-4173-b73e59679214