Claim total
$949.77
base $127.17 · payer covered $196.03
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-09-27
- Stop
- 2019-09-27
The parties
- Patient
- patient Alberto Bogisich
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
Record id
0b021865-9b35-acd2-a7d4-f1ae9adcece8