Claim total
$949.77
base $127.17 · payer covered $398.08
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-06-11
- Stop
- 2022-06-11
The parties
- Patient
- patient Adam Jones
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Anthem
Record id
00229130-e769-8779-0c01-63df522cbbcb