Claim total
$3,949.34
base $155.66 · payer covered $3,899.34
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-02-24
- Stop
- 2025-02-24
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-858b-94e973c55283