Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2019-09-18
- Stop
- 2019-09-18
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Zofia Bosco
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-7af9-066acdbe804e