Claim total
$9,071.83
base $127.17 · payer covered $9,036.83
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-02-17
- Stop
- 2022-02-17
The parties
- Patient
- patient Otto Cameron Barrows
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Dual Eligible
Record id
3236b1f8-2bc1-3e38-d9a5-ba7f7645474c