Claim total
$15,068.25
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-12-10
- Stop
- 2025-12-10
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Pasquale Grimes
- Payer
- payer No insurance
Record id
043d6e13-0cc7-07f3-7a82-742c55000257