Claim total
$1,456.54
base $155.66 · payer covered $1,421.54
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2019-08-10
- Stop
- 2019-08-10
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00decd7e-554a-447f-28f7-80c328483307