Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2022-09-22
- Stop
- 2022-09-22
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-3e0d-714d011b25b6