Claim total
$14,842.77
base $127.17 · payer covered $11,874.22
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-09-05
- Stop
- 2024-09-05
The parties
- Patient
- patient Warren Kenny Blanda
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
27d90396-195c-bf7b-9aba-6f35414880f5