Claim total
$1,287.45
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2022-11-20
- Stop
- 2022-11-20
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
0266f4cc-2c2d-37bb-5161-ef1508b70124