Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2012-09-17
- Stop
- 2012-09-17
The parties
- Patient
- patient Josefina Amanda Kuhic
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
28281b8c-b6b1-f0a9-e259-bc035458c8b6