Claim total
$4,252.58
base $76.30 · payer covered $4,217.58
The visit
- Class
- Emergency
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2025-05-20
- Stop
- 2025-05-20
The parties
- Patient
- patient Connie Buck Hane
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Dual Eligible
Record id
02070c62-d383-1025-a280-c733010c0d27