Claim total
$4,385.40
base $127.17 · payer covered $4,335.40
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-07-19
- Stop
- 2017-07-19
The parties
- Patient
- patient Gilda Estell Emard
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicaid
Record id
1d039546-6fd0-d85e-2f17-10423ccee5a4