Claim total
$16,569.23
base $127.17 · payer covered $6,513.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-11-14
- Stop
- 2018-11-14
The parties
- Patient
- patient Carmen Ramona Fonseca
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Humana
Record id
2cc6efe0-8e4a-8ccd-4295-b1b9b8715dc1