Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Chronic intractable migraine without aura124171000119105
- Start
- 1997-01-24
- Stop
- 1997-01-24
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-411d-2ffe62cff19f