Claim total
$17,044.61
base $155.66 · payer covered $17,044.61
The visit
- Class
- Ambulatory
- Code
- 308335008
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2024-01-27
- Stop
- 2024-01-27
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
0266f4cc-2c2d-37bb-2395-f0e3615432d0