Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-05
- Stop
- 2021-03-05
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-db52-5e20fa3361d0