Claim total
$9,953.25
base $127.17 · payer covered $7,962.61
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-04-16
- Stop
- 2025-04-16
The parties
- Patient
- patient Dara Dicki
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicare
Record id
3681da1b-d694-6521-928f-4fe22d24a0db