Claim total
$15,068.25
base $155.66 · payer covered $15,018.25
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-08-12
- Stop
- 2025-08-12
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-15b7-45e708f3d102