Claim total
$127.17
base $127.17 · payer covered $82.38
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1989-11-28
- Stop
- 1989-11-28
The parties
- Patient
- patient Jimmie Micah Predovic
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicare
Record id
2c84ecc3-1d6b-8ca5-738f-91b74eb94c94