Claim total
$1,658.06
base $155.66 · payer covered $1,608.06
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2016-02-04
- Stop
- 2016-02-04
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-12ef-4a9c9666d416