Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2015-11-26
- Stop
- 2015-11-26
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Lovie Turcotte
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-f9c2-012338693cf1