Administration of vaccine to produce active immunity

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patient Christoper Rogelio Schulist
Administration of vaccine to produce active immunity

Claim total

$291.66

base $155.66 · payer covered $241.66

The visit

Class: Outpatient
Code: 33879002
Reason: —
Start: 2021-03-06
Stop: 2021-03-06

The parties

Patient: patient Christoper Rogelio Schulist
Provider: provider Kelvin Reichel
Care site: care site Minneapolis VA Health Care System
Payer: payer Medicaid

Record id 03d1ce86-efe3-018d-f484-3f6e34895aa7