Claim total
$3,883.80
base $155.66 · payer covered $3,833.80
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2020-01-11
- Stop
- 2020-01-11
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-9fc8-e5b8837eb14f