Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-23
- Stop
- 2021-03-23
The parties
- Patient
- patient Blake Rudolph Von
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Aetna
Record id
01986319-54e6-598a-831e-e0833976ada8