Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2019-10-27
- Stop
- 2019-10-27
The parties
- Patient
- patient Minnie Cassin
- Provider
- provider Leta Sipes
- Payer
- payer Anthem
Record id
01e5652d-7e46-45b8-45a3-41dc3350c1f3