Claim total
$4,847.93
base $93.39 · payer covered $2,908.75
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-01-03
- Stop
- 2017-01-04
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-6069-38d91f5428ea