Claim total
$631.25
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-09-06
- Stop
- 2012-09-06
The parties
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
0366d403-b006-0b76-58f2-b47de768873a