Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-11-16
- Stop
- 2022-11-16
The parties
- Patient
- patient Ramon Josef Hagenes
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Dual Eligible
Record id
358aeebf-9459-7875-08a0-4816ba1cbe12