Claim total
$11,589.13
base $155.66 · payer covered $5,022.96
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2024-03-13
- Stop
- 2024-03-13
The parties
- Provider
- provider Belkis Blick
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-6542-8752bbfd444e