Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2024-08-21
- Stop
- 2024-08-21
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-b799-bcde83b068fe