Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2016-09-27
- Stop
- 2016-09-27
The parties
- Patient
- patient Tawna Shirly Reilly
- Provider
- provider Juli Predovic
- Care site
- care site KINDRED AT HOME
- Payer
- payer Medicaid
Record id
1894ea31-da3f-f986-c9dd-4878c761432b