Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2025-10-20
- Stop
- 2025-10-20
The parties
- Patient
- patient Fawn Fred Considine
- Provider
- provider Bryce Prohaska
- Care site
- care site CHI HEALTH AT HOME
- Payer
- payer Dual Eligible
Record id
3ac9b22c-79ba-7b95-4daa-0982b3efc98b