Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1997-05-15
- Stop
- 1997-05-15
The parties
- Patient
- patient Elden Cary DuBuque
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Dual Eligible
Record id
2f6fe81f-21ca-2f76-f68c-8dadc506c7e2