Claim total
$11,642.67
base $127.17 · payer covered $9,314.14
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-05-11
- Stop
- 2019-05-11
The parties
- Patient
- patient Nadine Jennette Blanda
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
2fd4d5da-96ab-f21b-5aae-7463d86961bd