Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2025-11-23
- Stop
- 2025-11-23
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-b112-c1059c3b3a16