Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2023-02-18
- Stop
- 2023-02-18
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider Malena Wilderman
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-8774-692359c4f90d