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
- 2017-05-18
- Stop
- 2017-05-18
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Cigna Health
Record id
03cbffbc-74a2-befb-b163-02ece12b813e