Claim total
$5,520.25
base $127.17 · payer covered $5,470.25
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-02-19
- Stop
- 2024-02-19
The parties
- Patient
- patient Nicky Kristi Wiegand
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
0358d022-e88b-b208-1b2b-ae7d159cfd2a