Claim total
$13,109.86
base $155.66 · payer covered $4,209.52
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-01-13
- Stop
- 2024-01-14
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-21a8-a1ff0e90fad9