Claim total
$3,935.75
base $127.17 · payer covered $3,900.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-05-29
- Stop
- 2025-05-29
The parties
- Patient
- patient Lelia Ariana Metz
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Dual Eligible
Record id
28793fbe-ecef-a924-63a3-9d0156d6f184