Claim total
$1,212.29
base $155.66 · payer covered $848.60
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2024-09-22
- Stop
- 2024-09-22
The parties
- Provider
- provider Belkis Blick
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-9e33-fc14000b7d3b