Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2018-06-24
- Stop
- 2018-07-05
The parties
- Patient
- patient Martín Agustín Estrada
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Humana
Record id
0c77f232-d1be-55d2-02b1-14f27511e476