Claim total
$3,883.80
base $155.66 · payer covered $3,833.80
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2020-08-11
- Stop
- 2020-08-11
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-fb22-3eaa9aa5e71c