Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-01-20
- Stop
- 2017-01-20
The parties
- Patient
- patient Jannette Hegmann
- Provider
- provider Camelia Hodkiewicz
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
3756471c-1eae-803d-7494-ff2e3c0b6c94