Claim total
$1,224.99
base $155.66 · payer covered $857.49
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2024-03-24
- Stop
- 2024-03-24
The parties
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-a97c-ae461719ec2c