Claim total
$566.96
base $155.66 · payer covered $453.57
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2024-12-04
- Stop
- 2024-12-04
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
03563bad-3832-f030-348a-6f5204ed7db9