Claim total
$1,267.46
base $155.66 · payer covered $1,267.46
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2023-11-19
- Stop
- 2023-11-19
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
0266f4cc-2c2d-37bb-9a0e-91048b6dd264