Claim total
$9,062.51
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2015-08-31
- Stop
- 2015-08-31
The parties
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer No insurance
Record id
1e015ce5-bd6b-3647-76bb-2a9b4cd9f929