Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-26
- Stop
- 2021-04-26
The parties
- Patient
- patient Elliot Blaine Buckridge
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
00a5a31e-a2f8-175f-6e47-9f1776e1fcfe