Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1969-03-01
- Stop
- 1969-03-01
The parties
- Patient
- patient Elbert Jamar Grant
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
1f492d1b-46b8-92c2-3ca4-6cba1c5b208e