Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-03-30
- Stop
- 2017-03-31
The parties
- Patient
- patient Spencer Olen Fay
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
127cedd0-f1be-4cc1-5029-58574a08b3b0