Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2023-12-30
- Stop
- 2023-12-30
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Marcus Douglas
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-f74c-a540c41013b1