Claim total
$900.18
base $93.39 · payer covered $850.18
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2022-05-04
- Stop
- 2022-05-05
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-d9b0-32fa48ea79a9