Claim total
$10,514.83
base $155.66 · payer covered $8,083.06
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2024-06-29
- Stop
- 2024-06-29
The parties
- Patient
- patient Leslee Christiansen
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Anthem
Record id
01280686-ae2e-42f0-fda4-f48c29f47897