Claim total
$5,267.25
base $93.39 · payer covered $5,232.25
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2023-09-16
- Stop
- 2023-09-16
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00decd7e-554a-447f-b04f-bb77554182b7