Claim total
$291.66
base $155.66 · payer covered $141.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2024-05-04
- Stop
- 2024-05-04
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Estelle Kling
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-b8c3-a17f306cdd81