Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 183478001
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2020-08-08
- Stop
- 2020-08-08
The parties
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicaid
Record id
014b9cfb-a71a-d032-a61e-b4e349f08cd0