Claim total
$3,968.49
base $155.66 · payer covered $1,582.00
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2023-05-21
- Stop
- 2023-05-21
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
0266f4cc-2c2d-37bb-e229-de6ab88374eb