Claim total
$127.17
base $127.17 · payer covered $101.67
The visit
- Class
- Emergency
- Code
- 183478001
- Reason
- diagnosis concept Asthma195967001
- Start
- 2023-12-28
- Stop
- 2023-12-28
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-9415-aeba2cb47352