Claim total
$830.53
base $93.39 · payer covered $795.53
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-12-01
- Stop
- 2021-12-02
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-d219-25cd-c10b004dadd2