Claim total
$4,096.91
base $127.17 · payer covered $2,140.02
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-06-02
- Stop
- 2019-06-02
The parties
- Patient
- patient Cheri Jonna Gutmann
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer UnitedHealthcare
Record id
22220d10-33d3-225a-3b35-192514fd5943