Claim total
$3,821.57
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2021-09-04
- Stop
- 2021-09-04
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
044947be-396f-8eb7-9a91-69c9b8c68cbc