Claim total
$15,068.25
base $155.66 · payer covered $15,033.25
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2023-01-07
- Stop
- 2023-01-07
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Rosio Gleason
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-4e4f-3ffa3040c081