Claim total
$1,212.29
base $155.66 · payer covered $1,162.29
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2018-02-07
- Stop
- 2018-02-07
The parties
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-2718-bfd8beb2624c