Claim total
$5,048.73
base $113.13 · payer covered $4,998.73
The visit
- Class
- Skilled nursing facility
- Code
- 32485007
- Reason
- Patient transfer to skilled nursing facility25675004
- Start
- 2025-11-23
- Stop
- 2025-11-28
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-bf7c-27ba8f0ee58e