Claim total
$5,192.08
base $93.39 · payer covered $2,637.45
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2019-04-02
- Stop
- 2019-04-02
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-fa59-0e497b6e02e2