Claim total
$11,448.56
base $155.66 · payer covered $11,413.56
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-06-01
- Stop
- 2023-06-01
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-fb65-dbf1be3081e9