Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2022-08-25
- Stop
- 2022-08-25
The parties
- Patient
- patient Lakenya Rowena Yost
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
059f80d2-8b9a-47e2-32ef-912adfe9f8ff