Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-06-24
- Stop
- 2017-06-24
The parties
- Patient
- patient Shiloh Barbra Aufderhar
- Provider
- provider Alia Gaylord
- Care site
- care site MIDWEST HOME HEALTHCARE LLC
- Payer
- payer Anthem
Record id
390fed25-ddad-3781-3388-211a8ec7a500