Claim total
$3,883.80
base $155.66 · payer covered $3,833.80
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-10-23
- Stop
- 2019-10-23
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-510d-af56ae7c0040