Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2025-02-08
- Stop
- 2025-02-08
The parties
- Patient
- patient Marsha Dodie Kuvalis
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
062d51e6-50d3-3fdf-0350-ef537af115dc