Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-01-31
- Stop
- 2021-01-31
The parties
- Patient
- patient Penny Shona Schaden
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03e70281-0fa0-c7c6-c248-bfe4a4cfc02b