Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-12-25
- Stop
- 2018-12-25
The parties
- Patient
- patient Quintin Alton Blick
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Humana
Record id
0c6b5cef-579a-b2bd-a93d-9881e64710ff