Claim total
$56,069.11
base $155.66 · payer covered $56,034.11
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-09-02
- Stop
- 2020-09-02
The parties
- Patient
- patient Adella Mitchell Erdman
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
37dacb37-2dca-f6a0-2aee-f2a0270fffc0