Claim total
$2,597.78
base $155.66 · payer covered $2,562.78
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-05-07
- Stop
- 2025-05-07
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00decd7e-554a-447f-5360-8b89b06021ce