Administration of vaccine to produce active immunity

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patient Pok Shane Strosin
Administration of vaccine to produce active immunity

Claim total

$291.66

base $155.66 · payer covered $46.93

The visit

Class: Outpatient
Code: 33879002
Reason: —
Start: 2023-06-21
Stop: 2023-06-21

The parties

Patient: patient Pok Shane Strosin
Provider: provider Dale Mertz
Care site: care site HENNEPIN COUNTY MEDICAL CENTER 1
Payer: payer Medicare

Record id 00162663-d9d1-4955-9763-5724145522f8