Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-15
- Stop
- 2021-03-15
The parties
- Provider
- provider Janette Fisher
- Payer
- payer Dual Eligible
Record id
04481159-34f8-6925-4f33-174d59c792ea