Claim total
$1,302.14
base $155.66 · payer covered $1,041.72
The visit
- Class
- Ambulatory
- Code
- 310061009
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2018-10-07
- Stop
- 2018-10-07
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-a432-788e-f73ca3d3eac8