Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-21
- Stop
- 2021-04-21
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Ramiro Boehm
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-7ccd-a7b0a8e9275c