Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-22
- Stop
- 2021-04-22
The parties
- Patient
- patient Son Lesley Hauck
- Provider
- provider Michael Dibbert
- Payer
- payer No insurance
Record id
01d28099-b492-968b-7935-c964cac2de87