Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2017-09-13
- Stop
- 2017-09-13
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
044947be-396f-8eb7-6117-0ac8e0c85f0e