Claim total
$12,451.55
base $127.17 · payer covered $9,961.24
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2006-11-11
- Stop
- 2006-11-11
The parties
- Patient
- patient Roy Billie Ankunding
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
2cc69e6e-eaec-c9c0-3cfa-72ba4dcaee3e