Claim total
$640.69
base $93.39 · payer covered $640.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2017-04-13
- Stop
- 2017-04-13
The parties
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-49fb-e081c4bb0513