Claim total
$3,649.30
base $155.66 · payer covered $3,599.30
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2021-07-26
- Stop
- 2021-07-26
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Floyd Toy
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-60c9-896d24fc65eb