Claim total
$127.17
base $127.17 · payer covered $30.36
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-08-21
- Stop
- 2018-08-21
The parties
- Patient
- patient Daron Cormier
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
061edbc8-fb70-a6fd-c0c9-8a3235774265