Claim total
$2,421.41
base $155.66 · payer covered $2,277.29
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-09-21
- Stop
- 2025-09-21
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-25f9-1632e65d0ac8