Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-14
- Stop
- 2021-03-14
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Stephaine O'Keefe
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-68c9-4db5e351f248