Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1992-04-17
- Stop
- 1992-04-17
The parties
- Patient
- patient Stevie Gorczany
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
1cb87270-7b3e-ee91-62e7-3090eaf68fad