Claim total
$1,530.04
base $155.66 · payer covered $1,480.04
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2017-11-09
- Stop
- 2017-11-09
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-f924-f80259a9361b