Claim total
$640.69
base $93.39 · payer covered $384.41
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2022-06-05
- Stop
- 2022-06-05
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-572f-5678922c362f