Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-14
- Stop
- 2021-04-14
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-b081-4272779995b7