Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2025-05-21
- Stop
- 2025-05-21
The parties
- Patient
- patient Marsha Dodie Kuvalis
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
062d51e6-50d3-3fdf-e46c-a7932e9f8aa0