Claim total
$1,212.29
base $155.66 · payer covered $848.60
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-01-11
- Stop
- 2019-01-11
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Leta Sipes
Record id
00cb11fd-f3f7-0950-511c-51a9c3f77e0e