Claim total
$16,517.46
base $127.17 · payer covered $16,482.46
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-06-04
- Stop
- 2024-06-05
The parties
- Patient
- patient Wendie Kellie Reynolds
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Dual Eligible
Record id
2d63fa27-766d-775f-f027-e4da494ac03d