Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2021-11-20
- Stop
- 2021-11-20
The parties
- Patient
- patient Nanci Lourie Rath
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
019cb7db-9e62-def9-a068-c5227532f2e2