Claim total
$4,252.58
base $76.30 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2018-06-18
- Stop
- 2018-06-18
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer No insurance
Record id
044947be-396f-8eb7-3ac4-c283a3dd9b5e