Claim total
$127.17
base $127.17 · payer covered $71.50
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-06-09
- Stop
- 2022-06-09
The parties
- Patient
- patient Cassandra Teofila Stamm
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicare
Record id
39fcdcc4-3c12-057a-3d71-b7cee3a11604