Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-04-09
- Stop
- 2025-04-09
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Floyd Toy
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-bab2-1bd72d0d0690