Claim total
$11,548.63
base $127.17 · payer covered $5,014.80
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-04-21
- Stop
- 2021-04-21
The parties
- Patient
- patient Vance Archie Kirlin
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Humana
Record id
0b490094-beb0-b779-2eea-0bc0c93081de