Claim total
$425.60
base $93.39 · payer covered $390.60
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-01-15
- Stop
- 2025-01-16
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
03ef4f74-940b-d219-5c56-7dc5352dd17c