Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-10-18
- Stop
- 2021-10-18
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
01bd7d75-9405-280a-9c3f-72c1313ca83f