Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-14
- Stop
- 2021-04-14
The parties
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-1649-22708b8e0700