Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2023-05-13
- Stop
- 2023-05-13
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-4d81-e9eb399f77d9