Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2026-08-07
- Stop
- 2026-08-07
The parties
- Patient
- patient Caryl Tomiko Haag
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Humana
Record id
39c1e8cc-e1f0-b755-f69a-1fdd0d6d49d6