Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-31
- Stop
- 2021-05-31
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Criselda Bartell
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-69f7-9a3a9c5f97d9