Claim total
$538.47
base $127.17 · payer covered $430.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2015-04-24
- Stop
- 2015-04-24
The parties
- Patient
- patient Mitchell Buck Williamson
- Provider
- provider Ismael Botsford
- Care site
- care site WSCHS, INC - AGAPE CLINIC
- Payer
- payer Medicare
Record id
30e5ea2d-b852-2bba-950d-c5c757be2657