Claim total
$949.77
base $127.17 · payer covered $914.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-05-25
- Stop
- 2025-05-25
The parties
- Patient
- patient Sha Kohler
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Dual Eligible
Record id
19dce853-ad87-d82e-9def-5b8cd297e661