Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-01-21
- Stop
- 2025-01-21
The parties
- Patient
- patient Lacresha Mandy Labadie
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicaid
Record id
33029919-e5ea-d866-fb83-8750f26b0820