Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-06-28
- Stop
- 2021-06-28
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-4fd6-2acb3dad6375