Claim total
$177.83
base $93.39 · payer covered $142.26
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1996-11-07
- Stop
- 1996-11-07
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
056f2732-3438-a432-3edd-a415c63302e8