Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 1977-11-19
- Stop
- 1977-11-19
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-378c-36138c12e662