Claim total
$4,854.63
base $127.17 · payer covered $3,640.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2016-11-02
- Stop
- 2016-11-02
The parties
- Patient
- patient Modesto Kunze
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Anthem
Record id
1358e0d6-1806-b993-87d9-7d708e889f40