Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2018-09-22
- Stop
- 2018-09-22
The parties
- Patient
- patient Synthia Grady
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
33ff0b1a-8ac4-7085-c821-61f67548d57d