Claim total
$13,266.77
base $127.17 · payer covered $10,502.36
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2020-07-06
- Stop
- 2020-07-06
The parties
- Patient
- patient Colton Eloy Yost
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Medicare
Record id
00f38984-ead0-d444-2618-0eb1d3ebd91c