Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2022-01-09
- Stop
- 2022-01-09
The parties
- Patient
- patient Margo Green
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-41a0-2f161d430f0c