Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-08
- Stop
- 2021-05-08
The parties
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-b27f-81ac661c7855