Claim total
$4,918.16
base $127.17 · payer covered $3,934.53
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-10-13
- Stop
- 2018-10-13
The parties
- Patient
- patient Louie Petrina Ziemann
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
2db8ed08-2422-5c8b-45a3-4db28e6322fc