Claim total
$1,168.10
base $155.66 · payer covered $1,168.10
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept History of renal transplant161665007
- Start
- 2019-05-16
- Stop
- 2019-05-16
The parties
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-edfe-c03f1822ea01