Claim total
$1,264.76
base $93.39 · payer covered $1,214.76
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2019-03-09
- Stop
- 2019-03-09
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-f9ac-bdeaffa9412c