Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2020-02-21
- Stop
- 2020-02-22
The parties
- Patient
- patient Modesto Derick Blanda
- Provider
- provider Emmanuel Champlin
- Care site
- care site CREST VIEW HOME HEALTH CARE
- Payer
- payer UnitedHealthcare
Record id
13bbf0ff-280f-8cc9-e880-9a4b29d726c0