Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2024-06-04
- Stop
- 2024-06-04
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-a550-1c4c9ca8b540