Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-21
- Stop
- 2021-04-21
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Goldie O'Hara
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0130f9d2-4df9-4b02-09c3-9ad9fc72c840