Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-04-28
- Stop
- 2017-04-28
The parties
- Patient
- patient Josh Shane Leannon
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicare
Record id
1476d15d-eaee-a45a-5e48-a0b498116cf4