Claim total
$6,624.83
base $155.66 · payer covered $6,589.83
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2020-01-23
- Stop
- 2020-01-23
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Kelvin Reichel
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-08ce-12fe5f473d32