Claim total
$538.47
base $127.17 · payer covered $503.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2018-08-21
- Stop
- 2018-08-21
The parties
- Patient
- patient Waltraud Lily Yundt
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
- Payer
- payer Dual Eligible
Record id
1f58a428-477a-27c1-f196-cb9571393dd6