Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-10-07
- Stop
- 2018-10-07
The parties
- Patient
- patient Carmen Omer Mayer
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
36c86f70-85b0-1d4b-25c7-575e922b89d7