Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1967-02-22
- Stop
- 1967-02-22
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-2bc8-58c688d90fe7