Claim total
$6,446.67
base $127.17 · payer covered $6,396.67
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-03-30
- Stop
- 2025-03-30
The parties
- Patient
- patient Sherryl Dion Collier
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
2ff124fd-32f0-2d7e-d27a-87725f897053