Claim total
$978.26
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Blighted ovum35999006
- Start
- 1990-04-05
- Stop
- 1990-04-05
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
056f2732-3438-a432-1b1f-f67a5822de8e