Claim total
$536.30
base $125.00 · payer covered $486.30
The visit
- Class
- Virtual
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2022-08-31
- Stop
- 2022-09-01
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-1e37-0116e7d97d8b