Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2017-06-22
- Stop
- 2017-06-22
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Lanora Schowalter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0130f9d2-4df9-4b02-c674-00b70de4cf5c