Claim total
$915.99
base $93.39 · payer covered $625.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Sleep disorder39898005
- Start
- 1989-08-21
- Stop
- 1989-08-21
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
034c4f48-8c73-4f35-d929-52f8566b460f