Claim total
$566.96
base $155.66 · payer covered $531.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2025-01-08
- Stop
- 2025-01-08
The parties
- Patient
- patient Sammie Boehm
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
39002795-4e34-d79b-0a35-fafeb957ebfd