Claim total
$2,001.64
base $127.17 · payer covered $1,951.64
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Acute allergic reaction241929008
- Start
- 2018-09-06
- Stop
- 2018-09-06
The parties
- Patient
- patient Ferdinand Kasey Ernser
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicaid
Record id
062e401f-723c-d87d-5e6a-9b60969e6218