Claim total
$15,068.25
base $155.66 · payer covered $15,018.25
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2017-10-19
- Stop
- 2017-10-19
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-dc73-7ce821342463