Claim total
$21,995.04
base $155.66 · payer covered $21,945.04
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-04-02
- Stop
- 2025-04-02
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-623c-087574664500