Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-31
- Stop
- 2021-03-31
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Trinity Mraz
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-6c27-9610c1e3527e