Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-01-28
- Stop
- 2021-01-28
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Nanette Haley
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-918a-a725e989359d