Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-05-30
- Stop
- 2021-05-30
The parties
- Patient
- patient Brittanie Aida Volkman
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Humana
Record id
1c8ae97c-1916-d81f-d6a8-f5b35e1d67e6