Claim total
$4,854.63
base $127.17 · payer covered $3,726.45
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2012-10-11
- Stop
- 2012-10-11
The parties
- Patient
- patient Roy Billie Ankunding
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicare
Record id
2cc69e6e-eaec-c9c0-71da-e341ac65e4b7