Claim total
$291.66
base $155.66 · payer covered $117.25
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-11-11
- Stop
- 2021-11-11
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Michael Dibbert
- Payer
- payer Anthem
Record id
023818a4-3852-fbab-7a8a-6c1989aaf13e