Claim total
$12,894.85
base $127.17 · payer covered $4,843.33
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 1996-08-19
- Stop
- 1996-08-20
The parties
- Patient
- patient Queenie Van Keebler
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
046b1f1e-c36f-c080-92bb-a50502da32b3