Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2023-06-16
- Stop
- 2023-06-16
The parties
- Patient
- patient Anette Toya Brown
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
31533e40-3e99-a073-64ad-2911e6c96b21