Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-02-13
- Stop
- 2021-02-13
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Liz Kozey
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-593d-3020b7a3ca92