Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-05-07
- Stop
- 2021-05-07
The parties
- Patient
- patient Brendan Kasey Hettinger
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
0d09b896-2873-86dc-3de3-cc4fe8993d9e