Claim total
$219.95
base $93.39 · payer covered $184.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2018-03-14
- Stop
- 2018-03-14
The parties
- Patient
- patient Stacy Herzog
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
070c7867-fbf2-7941-2b68-50c36cfa6533