Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-11-12
- Stop
- 2024-11-12
The parties
- Patient
- patient Ruben Dorian Schaefer
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
1a4a2030-0e50-02f5-84d7-a677264bd69b