Claim total
$536.30
base $125.00 · payer covered $536.30
The visit
- Class
- Virtual
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2022-10-20
- Stop
- 2022-10-20
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-7b3e-91eb08a3e59d