Claim total
$10,663.82
base $127.17 · payer covered $10,613.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-12-08
- Stop
- 2017-12-08
The parties
- Patient
- patient Ayana Karine Shields
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
39583d22-69ce-add7-7946-c6970008680c