Claim total
$4,382.21
base $155.66 · payer covered $4,332.21
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2021-10-25
- Stop
- 2021-10-25
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-aca6-ece9d5771f61