Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2023-01-04
- Stop
- 2023-01-05
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-d219-1e2d-4b0e03196eae