Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2021-07-31
- Stop
- 2021-07-31
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Mose Kertzmann
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-c526-af5621396d69