Claim total
$6,937.96
base $155.66 · payer covered $612.54
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2020-07-19
- Stop
- 2020-07-19
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-65f3-8edbbb74ca2a