Claim total
$3,763.01
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2020-06-30
- Stop
- 2020-06-30
The parties
- Patient
- patient Cyndi Tromp
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
01936333-6290-e7a2-7f81-d05d8b3905bd