Claim total
$3,883.80
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-03-24
- Stop
- 2019-03-24
The parties
- Provider
- provider Bethanie Wintheiser
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-7def-a0b34ffc704b