Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-07-03
- Stop
- 2021-07-03
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Leta Sipes
- Payer
- payer Medicare
Record id
01845754-7d83-d7eb-864e-f086ad4640d8