Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-17
- Stop
- 2021-05-17
The parties
- Patient
- patient Elliot Blaine Buckridge
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
00a5a31e-a2f8-175f-b979-73d00fda172c