Claim total
$518.19
base $127.17 · payer covered $468.19
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2020-11-21
- Stop
- 2020-11-21
The parties
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-1d69-843ae60f6bcd