Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-02-19
- Stop
- 2021-02-19
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-440e-0065e6afcd11