Claim total
$3,935.75
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2000-08-11
- Stop
- 2000-08-11
The parties
- Patient
- patient Ciera Sharell Koelpin
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
2addfeac-df52-3556-3d60-a370b982aa63