Claim total
$98.96
base $93.39 · payer covered $48.96
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2026-07-22
- Stop
- 2026-07-23
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-0cd4-9cb1a0cc56a5