Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-06-07
- Stop
- 2022-06-07
The parties
- Patient
- patient Bernetta Dare
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicaid
Record id
2253ffad-5335-0a17-61ff-e4ff346c5954