Claim total
$3,804.53
base $155.66 · payer covered $2,663.17
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2020-04-10
- Stop
- 2020-04-10
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Leta Sipes
Record id
00cb11fd-f3f7-0950-05d8-4990d62d618c