Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1993-01-05
- Stop
- 1993-01-05
The parties
- Patient
- patient Irvin Douglas
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
3692c1f2-828a-56e2-10c5-042981a8f013