Claim total
$16,046.71
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-10-07
- Stop
- 2024-10-07
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-8eb7-65b7-3108bd0a19a0