Claim total
$10,192.61
base $127.17 · payer covered $2,615.33
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-06-22
- Stop
- 2021-06-22
The parties
- Patient
- patient Carlton Anton Kunze
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Humana
Record id
2c989209-5743-e509-603d-053031b93a4b