Claim total
$3,883.80
base $155.66 · payer covered $3,833.80
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2021-06-05
- Stop
- 2021-06-05
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-a31c-1d8830b3c8b3