Claim total
$13,386.71
base $127.17 · payer covered $10,709.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-02-05
- Stop
- 2018-02-05
The parties
- Patient
- patient Kelvin Johnny Hirthe
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
292b5aae-02fc-4e2f-78d3-74900965cd1c