Claim total
$949.77
base $127.17 · payer covered $914.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-11-13
- Stop
- 2021-11-13
The parties
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-b8ac-948c417e6dfc