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
- 1980-03-17
- Stop
- 1980-03-17
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-688a-d03079ae87d8