Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2026-04-21
- Stop
- 2026-04-21
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Berry Borer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-3159-6e9b10ed7d9b