Claim total
$139.51
base $93.39 · payer covered $104.51
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2023-11-01
- Stop
- 2023-11-02
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
03ef4f74-940b-d219-1bd6-971e0922dcdc