Claim total
$949.77
base $127.17 · payer covered $664.84
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-12-12
- Stop
- 2017-12-12
The parties
- Patient
- patient Louann Kulas
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
Record id
2a098ee4-b472-5a9e-e419-37a0bec50bbc