Claim total
$8,856.88
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-12-27
- Stop
- 2025-12-27
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
044947be-396f-8eb7-4fd4-9913801449be