Claim total
$291.66
base $155.66 · payer covered $141.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2025-11-06
- Stop
- 2025-11-06
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Marcus Douglas
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-b2c4-9cd29caf29a6