Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-11-04
- Stop
- 2021-11-04
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-05dc-93ff0a7b4f7c