Claim total
$1,212.29
base $155.66 · payer covered $1,162.29
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2018-10-14
- Stop
- 2018-10-14
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Mose Kertzmann
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-a3ea-0cf4dadcceb0