Claim total
$1,116.43
base $93.39 · payer covered $893.12
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2000-08-09
- Stop
- 2000-08-09
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-1779-3b714fc51f1b