Claim total
$3,382.70
base $155.66 · payer covered $3,332.70
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-10-20
- Stop
- 2025-10-20
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-db4f-04e8ba6721a9