Claim total
$9,679.63
base $127.17 · payer covered $9,629.63
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2010-01-08
- Stop
- 2010-01-09
The parties
- Patient
- patient Otis Jed Price
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
1d8b9eda-b86e-378b-1b2c-89359f54577f