Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 1963-08-08
- Stop
- 1963-08-08
The parties
- Patient
- patient Adolph Junior Crist
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
3672386e-ce21-51ce-ee1c-4fcf04c2c3a6