Claim total
$18,796.39
base $155.66 · payer covered $18,646.39
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-10-07
- Stop
- 2025-10-07
The parties
- Patient
- patient Queen Sharika Fay
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
02c148c0-182c-a5fd-70b2-0b06ac6894f5