Claim total
$4,992.38
base $127.17 · payer covered $4,942.38
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-07-25
- Stop
- 2022-07-25
The parties
- Patient
- patient Eduardo Reuben Gutmann
- Provider
- provider Shellie Pacocha
- Care site
- care site MILS HOME HEALTH CARE AGENCY
- Payer
- payer Medicaid
Record id
2fc8278e-6ad0-aff8-e6f3-461994f8dcf9