Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2017-06-01
- Stop
- 2017-06-01
The parties
- Patient
- patient Leonard Zachery Jast
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
19b5cd44-0ae9-6290-4f04-273d5471003e