Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1998-10-22
- Stop
- 1998-10-22
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-990d-bf935c5bb343