Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2022-08-29
- Stop
- 2022-08-29
The parties
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0c395301-a8da-7a14-a231-c9f70d99ed5b