Claim total
$330.05
base $155.66 · payer covered $264.04
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2018-10-07
- Stop
- 2018-10-07
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
056f2732-3438-a432-1474-b2fffe49d109