Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-28
- Stop
- 2021-04-28
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider Mary Harvey
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-d755-e57df974e0cc