Claim total
$9,880.72
base $155.66 · payer covered $9,830.72
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2017-01-06
- Stop
- 2017-01-06
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-e713-458e8e6f2374