Claim total
$3,883.80
base $155.66 · payer covered $3,733.80
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2021-01-14
- Stop
- 2021-01-14
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-0d30-b30dd7aa23a4