Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-01-26
- Stop
- 2021-01-26
The parties
- Patient
- patient Nanci Lourie Rath
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
019cb7db-9e62-def9-25ce-7f468f8d4e10