Claim total
$155.66
base $155.66 · payer covered $93.40
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2018-05-15
- Stop
- 2018-05-15
The parties
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
032df52f-9699-4603-8306-0eda65eb5b67