Claim total
$949.77
base $127.17 · payer covered $914.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-02-20
- Stop
- 2024-02-20
The parties
- Patient
- patient Josefina Amanda Kuhic
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Dual Eligible
Record id
28281b8c-b6b1-f0a9-6fde-5e93bd966c37