Claim total
$12,146.46
base $127.17 · payer covered $12,111.46
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-07-08
- Stop
- 2022-07-08
The parties
- Patient
- patient Dwain Ruecker
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Dual Eligible
Record id
0887d860-7552-81d7-6ff8-3ed6c59dbccc