Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-01-15
- Stop
- 2021-01-15
The parties
- Patient
- patient Lynne Aileen Kunde
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Aetna
Record id
0adabb52-a752-f68a-bedf-41ac489f294a