Claim total
$4,846.12
base $127.17 · payer covered $4,696.12
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2011-05-24
- Stop
- 2011-05-24
The parties
- Patient
- patient Lillian Billye O'Conner
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
3248f34a-b42c-3b54-da9a-ba82e9b755b4