Claim total
$3,918.65
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Acute allergic reaction241929008
- Start
- 2022-04-05
- Stop
- 2022-04-05
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-63c5-949b442f38ce