Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-01-22
- Stop
- 2021-01-22
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-8db3-84723a3781e7