Claim total
$538.47
base $127.17 · payer covered $503.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 1981-11-12
- Stop
- 1981-11-12
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Dual Eligible
Record id
195810b4-1136-614f-ed72-0e69b0324d9a