Claim total
$11,393.93
base $127.17 · payer covered $11,343.93
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-08-02
- Stop
- 2021-08-02
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-28e2-658e-9dd25b0252e8