Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2022-04-13
- Stop
- 2022-04-13
The parties
- Patient
- patient Caleb Ted Hilll
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Anthem
Record id
36c52f95-f5b0-b5d2-6fa0-11c9ea854ce7