Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2022-09-22
- Stop
- 2022-09-22
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
032e4024-8595-f612-484e-c8798983e1c4