Claim total
$1,310.86
base $93.39 · payer covered $1,048.68
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-10-15
- Stop
- 2025-10-15
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-3f76-1417c25580a1