Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2026-02-26
- Stop
- 2026-02-26
The parties
- Patient
- patient Lanny Casper
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
2b3be322-b6d7-acfd-0712-405ae538f909