Claim total
$7,134.13
base $127.17 · payer covered $682.81
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-11-26
- Stop
- 2017-11-26
The parties
- Patient
- patient Buddy Simon Bogisich
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Humana
Record id
18b7170d-1f17-f6bb-648e-469e804fa972