Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2018-05-13
- Stop
- 2018-05-13
The parties
- Patient
- patient Garrett Lon Kertzmann
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Humana
Record id
0866e065-67e0-4dd0-66be-65c4db7ee82c