Claim total
$3,935.75
base $127.17 · payer covered $3,829.14
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-01-12
- Stop
- 2020-01-12
The parties
- Patient
- patient Kenton Raynor
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Medicaid
Record id
341f9b14-1f90-51b5-1fb5-46ffaa6fbbc4