Claim total
$2,212.33
base $127.17 · payer covered $2,162.33
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-03-08
- Stop
- 2025-03-08
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Medicaid
Record id
044947be-396f-8eb7-b369-2c0b7f2af182