Claim total
$1,212.29
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2026-02-27
- Stop
- 2026-02-27
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
031e24ca-9978-b353-17a6-2f5f3b4e4c2d