Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-04-07
- Stop
- 2021-04-07
The parties
- Patient
- patient Elois Felisha Simonis
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer No insurance
Record id
39162559-8ecc-f67b-b8fe-df232fbbbfb8