Claim total
$127.17
base $127.17 · payer covered $89.02
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2019-10-14
- Stop
- 2019-10-14
The parties
- Patient
- patient Louann Kulas
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
Record id
2a098ee4-b472-5a9e-55db-f7fbeb139c96