Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2004-12-11
- Stop
- 2004-12-11
The parties
- Patient
- patient Jonas Raymond Haley
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2e07b33a-27a0-451d-6122-c45b4edb6e2d