Felicetti Team

Patient

Patient name*

Patient DOB*

Date of injury*

Facility

Facility name*

Pick one of the firm's billing facilities — the address auto-fills below.

Tax ID

Optional — printed on the bill when provided.

NPI #

Optional — printed on the bill when provided.

Treatment

One row per procedure. Paste the sentence as it appears in the demand’s Nature of Injury (e.g. “Bilateral L3, L4 and L5 Medial Branch Block Injection Under Fluoroscopic Needle Guidance”). The parser detects side, spinal region, and level count, then assigns the right CPT codes and prices.

Date of service

Treatment sentence

Drafts auto-save to this browser.