Claim total
$5,201.74
base $76.30 · payer covered $408.61
The visit
- Class
- Emergency
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2010-10-02
- Stop
- 2010-10-02
The parties
- Patient
- patient Felipe Dwain Keebler
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Humana
Record id
02f04cf4-122a-e8d3-55fa-3706dee63f0a