Claim total
$949.77
base $127.17 · payer covered $847.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-10-24
- Stop
- 2019-10-24
The parties
- Patient
- patient Dan Barton Brown
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
383ddc6b-4540-35e6-82c4-fdd41dfda7f7