Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-26
- Stop
- 2021-05-26
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Burton O'Conner
- Payer
- payer No insurance
Record id
043d6e13-0cc7-07f3-d3fe-0c9475b97f66