Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2026-03-01
- Stop
- 2026-03-01
The parties
- Patient
- patient Nicky Kristi Wiegand
- Provider
- provider Noreen Hudson
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
0358d022-e88b-b208-a195-d6e38cd31413