Claim total
$1,361.07
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of mandible263172003
- Start
- 2021-08-15
- Stop
- 2021-08-15
The parties
- Patient
- patient Maryland Hermine Ryan
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Aetna
Record id
2594c568-de7d-2084-916a-cd9ef7dccf4f