Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2022-05-01
- Stop
- 2022-05-01
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01ce818c-8f9f-924a-e90f-cfc40cf7fc02