Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2017-08-03
- Stop
- 2017-08-03
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Lanora Schowalter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-e65d-6b30c81e45a7