Claim total
$155.66
base $155.66 · payer covered $155.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-10-04
- Stop
- 2025-10-05
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-a6db-c963d98de87c