Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-11-06
- Stop
- 2022-11-06
The parties
- Patient
- patient Mignon Janay Johnson
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
0a37331a-7bd1-f3a9-fcea-d592f6138e8c