Claim total
$155.66
base $155.66 · payer covered $25.97
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2017-01-15
- Stop
- 2017-01-15
The parties
- Patient
- patient Lakenya Rowena Yost
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
059f80d2-8b9a-47e2-5ed5-5c8ca6b2dc1f