Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2016-11-13
- Stop
- 2016-11-13
The parties
- Patient
- patient Giovanni Riley Hilll
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicare
Record id
1e5a5554-7082-bc61-45c3-7712966d6e36