Claim total
$291.66
base $155.66 · payer covered $46.93
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-09-01
- Stop
- 2021-09-01
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
046c8377-6cc1-c8f9-e825-68975caaaa5c