Claim total
$4,382.21
base $155.66 · payer covered $4,382.21
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2023-03-19
- Stop
- 2023-03-19
The parties
- Provider
- provider Belkis Blick
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-1c28-3d95478a155b