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
- 2018-06-09
- Stop
- 2018-06-09
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
01845754-7d83-d7eb-795e-885604bec8e2