Claim total
$1,396.14
base $155.66 · payer covered $1,396.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-02-15
- Stop
- 2024-02-16
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-2d5b-5a4383bc9c98