Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-07-01
- Stop
- 2019-07-01
The parties
- Patient
- patient Dalton Hilario Miller
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Humana
Record id
1d6fb3af-6570-683b-0f7e-35c8f226fed3