Claim total
$4,794.17
base $155.66 · payer covered $205.92
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-06-22
- Stop
- 2019-06-22
The parties
- Patient
- patient Leslee Christiansen
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Cigna Health
Record id
01280686-ae2e-42f0-de4a-5e96ad248609