Claim total
$17,709.83
base $155.66 · payer covered $17,559.83
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2017-09-19
- Stop
- 2017-09-19
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-ff25-c8cb312a5a33