Claim total
$3,935.75
base $127.17 · payer covered $3,833.35
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-12-24
- Stop
- 2020-12-24
The parties
- Patient
- patient Brigette Green
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
326e20eb-b82a-a50f-fcba-0d647b875b64