Claim total
$77.54
base $75.00 · payer covered $0.00
The visit
- Class
- Virtual
- Code
- 185317003
- Reason
- —
- Start
- 2026-04-30
- Stop
- 2026-04-30
The parties
- Patient
- patient Michal Andrew Champlin
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
01866125-a841-a217-0840-442ec9feb97b