Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-13
- Stop
- 2021-05-13
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Catalina Weimann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-a552-bfda4d467d58