Claim total
$9,424.69
base $155.66 · payer covered $5,129.85
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2017-11-12
- Stop
- 2017-11-12
The parties
- Provider
- provider Charlena Adams
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-d408-b36ab01db064