Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of hip239872002
- Start
- 2015-02-15
- Stop
- 2015-02-15
The parties
- Patient
- patient Ayako Tynisha Konopelski
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2d5fef92-5b93-765b-88e1-df798e2c20d2