Claim total
$47,014.88
base $155.66 · payer covered $25,239.59
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-02-07
- Stop
- 2017-02-07
The parties
- Patient
- patient Jacquelin Leffler
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
1238e43a-68f7-e8e8-935c-6dd27f1f8bdc