Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-05-14
- Stop
- 2020-05-14
The parties
- Patient
- patient Doyle Thad Bartoletti
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
16c956d3-fda8-d605-8a6b-6b20e39b5d18