Claim total
$4,664.75
base $127.17 · payer covered $3,731.80
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2023-11-22
- Stop
- 2023-11-22
The parties
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
2c220e10-502c-5092-1226-d926093b20cc