Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-05-09
- Stop
- 2017-05-09
The parties
- Patient
- patient Latesha Olimpia Price
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
336a367a-9ecd-f668-b768-51ed54cc8e7e