Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Streptococcal sore throat43878008
- Start
- 2023-10-29
- Stop
- 2023-10-29
The parties
- Patient
- patient Brendon Marcos Sanford
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
032ec4eb-84a5-3e3f-ea22-f66f36226242