Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Child attention deficit disorder192127007
- Start
- 2014-03-29
- Stop
- 2014-03-29
The parties
- Patient
- patient Marcelino Sandy Grimes
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
119c5a6f-d47e-7703-d355-eab6ed9019ef