Claim total
$291.66
base $155.66 · payer covered $141.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-02
- Stop
- 2021-03-02
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-f8b3-ace3515a6a6d