Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-11-08
- Stop
- 2022-11-08
The parties
- Patient
- patient Royal Lehner
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
09f5bcd2-b8b2-331d-0bcb-819c3d744923