Claim total
$6,808.86
base $155.66 · payer covered $1,498.36
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2021-05-14
- Stop
- 2021-05-14
The parties
- Patient
- patient Marilynn Jaimie Pouros
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0126af27-a469-d3f6-34c2-b316d6d11a99