Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-08-03
- Stop
- 2022-08-03
The parties
- Patient
- patient Madlyn Milagros Bernhard
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
297c0d5b-b924-d8b6-6eb6-2ae8efdf952f