Claim total
$779.71
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1976-03-01
- Stop
- 1976-03-01
The parties
- Patient
- patient Raymundo Bradley Monahan
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
2387da0b-9a14-9a7e-d43d-ba034744694b