Claim total
$76.30
base $76.30 · payer covered $26.30
The visit
- Class
- Emergency
- Code
- 183452005
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 1990-09-27
- Stop
- 1990-09-27
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-ec82-052cce6d0e7a