Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2025-11-27
- Stop
- 2025-11-27
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-be44-2359323b1dc2