Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-10-13
- Stop
- 2019-10-13
The parties
- Patient
- patient Claud Roland Kutch
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer No insurance
Record id
2807bb3b-10eb-cf70-524a-c36fc19760e3