Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-18
- Stop
- 2021-05-18
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-6565-ed41e2d77528