Claim total
$28,678.85
base $127.17 · payer covered $22,943.09
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2026-03-07
- Stop
- 2026-03-07
The parties
- Patient
- patient Dara Dicki
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
3681da1b-d694-6521-288d-82c5f1df3760