Claim total
$3,883.80
base $155.66 · payer covered $3,833.80
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2018-03-30
- Stop
- 2018-03-30
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-a3a9-909309222133