Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-05
- Stop
- 2021-04-05
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Greta Gutmann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-f0c2-e7ac7bfeb951