Claim total
$1,370.84
base $155.66 · payer covered $1,370.84
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2024-12-22
- Stop
- 2024-12-22
The parties
- Provider
- provider Joshua Dickens
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-5ccf-26d0011f3865