Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2023-06-04
- Stop
- 2023-06-04
The parties
- Patient
- patient Martín Ramón Chacón
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicaid
Record id
0b2edf0d-f30f-28e2-4ac3-65f328436a51