Claim total
$3,883.80
base $155.66 · payer covered $3,107.04
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2018-09-12
- Stop
- 2018-09-12
The parties
- Provider
- provider Noreen Hudson
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
06444eb9-3bbb-5546-af9e-d75fa67892fe