Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Shellfish735029006
- Start
- 2016-04-14
- Stop
- 2016-04-14
The parties
- Patient
- patient Alva Randy Gislason
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
06b076c2-4241-661b-8704-fd70ada37604