Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-10-26
- Stop
- 2024-10-26
The parties
- Patient
- patient Conrad German Gutkowski
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Humana
Record id
12366ad9-64b5-a49b-57c3-bacbb0eaa9d9