Claim total
$538.47
base $127.17 · payer covered $488.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2022-03-24
- Stop
- 2022-03-24
The parties
- Patient
- patient Pierre Salvador Huel
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Medicaid
Record id
10b981a1-a78f-3ddf-8029-3ad78ba213c6