Claim total
$155.66
base $155.66 · payer covered $5.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2017-01-02
- Stop
- 2017-01-02
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Silas Conn
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-df58-edc77b339c87