Claim total
$971.52
base $93.39 · payer covered $821.52
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2021-01-14
- Stop
- 2021-01-14
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-db1c-28f6ff2c749c