Claim total
$711.28
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-04-01
- Stop
- 2021-04-01
The parties
- Patient
- patient Agueda Raelene Dibbert
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
2c2a55c2-b04c-0ce4-068e-806f7e4a36b7