Claim total
$4,382.21
base $155.66 · payer covered $2,983.10
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2022-08-13
- Stop
- 2022-08-13
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Liz Kozey
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-488e-815af30da844