Claim total
$3,883.80
base $155.66 · payer covered $2,718.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2019-12-01
- Stop
- 2019-12-01
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-3983-6eb14ef294f0