Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-10-13
- Stop
- 2021-10-13
The parties
- Patient
- patient Jefferson Fredrick Stamm
- Provider
- provider Jo Stiedemann
- Payer
- payer Humana
Record id
02e8a145-6422-3c9c-3889-321f0ba20a7a