Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-24
- Stop
- 2021-05-24
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Goldie O'Hara
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Cigna Health
Record id
006af299-d813-2b4f-68be-e61976637c3f