Claim total
$1,010.29
base $93.39 · payer covered $960.29
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-04-26
- Stop
- 2015-04-26
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-c725-690da66c9cfc