Claim total
$3,883.80
base $155.66 · payer covered $3,107.04
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-04-12
- Stop
- 2025-04-12
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Silas Conn
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-876f-366fe35d078e