Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2018-03-28
- Stop
- 2018-03-28
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-ac83-8feb1e6a5bd8