Claim total
$4,223.17
base $155.66 · payer covered $3,378.54
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2021-05-15
- Stop
- 2021-05-15
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Floyd Toy
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-d439-cbc5ba6145a6