Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-02-25
- Stop
- 2019-02-25
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-b449-6e748159caf7