Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2023-01-21
- Stop
- 2023-01-21
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
Record id
01bd7d75-9405-280a-f6f8-bd99e28c7a7e