Claim total
$291.66
base $155.66 · payer covered $141.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-29
- Stop
- 2021-05-29
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-6f61-05d5d9d1cccb