Claim total
$1,185.50
base $93.39 · payer covered $1,135.50
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2009-08-03
- Stop
- 2009-08-03
The parties
- Patient
- patient Gennie Morgan Olson
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
11f75ca9-f553-2c40-26bf-dbafcaf33cf5