Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-10-16
- Stop
- 2021-10-16
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
044947be-396f-8eb7-23b9-16f9f22adce5