Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-11-28
- Stop
- 2021-11-28
The parties
- Patient
- patient Rex Jules Denesik
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
06303127-1d9c-5fa8-b2be-c537bb29ccf4