Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2026-02-23
- Stop
- 2026-02-23
The parties
- Patient
- patient Vern Isreal White
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Medicaid
Record id
37f95691-9da2-3eb9-a8c3-e87b917e81b4