Claim total
$2,623.46
base $155.66 · payer covered $2,623.46
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2026-02-11
- Stop
- 2026-02-11
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-ecd7-9c27158e1f31