Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-02-12
- Stop
- 2024-02-12
The parties
- Patient
- patient Delois Misti Kassulke
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Aetna
Record id
338d8130-ed7a-f2fb-a1cd-7c6c7e6f4d0e