Claim total
$291.66
base $155.66 · payer covered $141.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-30
- Stop
- 2021-04-30
The parties
- Patient
- patient Lee Scot Rosenbaum
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
027e2621-860b-6019-63f4-9f8d30f4eb44