Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Viral sinusitis444814009
- Start
- 2024-04-01
- Stop
- 2024-04-01
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
034c4f48-8c73-4f35-20ac-8a7522986a83