Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2017-05-23
- Stop
- 2017-05-23
The parties
- Patient
- patient Mariano Green
- Provider
- provider Bennie Gutkowski
- Care site
- care site FAIRVIEW UNIVERSITY TRANS SERV
Record id
28193b56-5937-c165-2a30-6a75f4af5407