Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2001-11-29
- Stop
- 2001-11-30
The parties
- Patient
- patient Craig Olin Cassin
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicaid
Record id
255f4784-1651-1fb2-65e5-c168cc7c2181