Claim total
$36,116.51
base $155.66 · payer covered $36,066.51
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-05-28
- Stop
- 2016-05-28
The parties
- Patient
- patient Arlene Maurine Dibbert
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
147bb29a-9ad7-3264-7f78-f494afe87371