Claim total
$93.47
base $93.39 · payer covered $74.77
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-12-31
- Stop
- 2025-12-31
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-33f6-bf0ec6f584b4