Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-06-29
- Stop
- 2021-06-29
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Patrick Breitenberg
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-f141-68731e2940fa