Claim total
$15,068.25
base $155.66 · payer covered $11,919.70
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2026-08-18
- Stop
- 2026-08-18
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
046c8377-6cc1-c8f9-8534-9ffdd098fb15