Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2018-11-07
- Stop
- 2018-11-07
The parties
- Provider
- provider Leila Thiel
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-c7c3-7945746c2539