Claim total
$4,382.21
base $155.66 · payer covered $4,382.21
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2023-12-24
- Stop
- 2023-12-24
The parties
- Provider
- provider Joshua Dickens
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-ddf3-5ac198d6626c