Claim total
$2,164.75
base $155.66 · payer covered $2,114.75
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-04-21
- Stop
- 2025-04-21
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Marcus Douglas
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-4e22-8466ec1e5258