Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-10
- Stop
- 2021-05-10
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
0453bbfc-4b53-3293-f9c6-3d078e7fb5a9