Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2021-05-30
- Stop
- 2021-05-30
The parties
- Patient
- patient Emilie Blanca Pollich
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
13928554-f499-6456-a52e-0577375cb38a