Claim total
$3,207.03
base $155.66 · payer covered $3,157.03
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2022-04-25
- Stop
- 2022-04-25
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-4bc3-12f80c560444