Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2023-09-17
- Stop
- 2023-09-17
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-6f0e-2169d8fd1863