Claim total
$291.66
base $155.66 · payer covered $291.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-05
- Stop
- 2021-04-05
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
04bc601b-5b17-3710-cef5-7d9c6efefb3d