Claim total
$9,734.40
base $127.17 · payer covered $9,684.40
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-08-31
- Stop
- 2017-08-31
The parties
- Patient
- patient Hien Shasta Nikolaus
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicaid
Record id
1feed5c5-ef44-d1c7-b80f-fe63b301a2a2