Claim total
$978.26
base $155.66 · payer covered $782.61
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2024-08-21
- Stop
- 2024-08-21
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
046c8377-6cc1-c8f9-6a75-980db501768b