Claim total
$3,222.96
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-08-23
- Stop
- 2019-08-23
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
032e4024-8595-f612-166a-c1aabc48329b