Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Peanut762952008
- Start
- 1930-10-04
- Stop
- 1930-10-04
The parties
- Patient
- patient Nicole Kelsi Sipes
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0cb983be-15db-fabe-bd07-657234517811