Claim total
$907.69
base $76.30 · payer covered $872.69
The visit
- Class
- Inpatient
- Code
- 185389009
- Reason
- diagnosis concept Sleep disorder39898005
- Start
- 2014-04-25
- Stop
- 2014-04-26
The parties
- Patient
- patient Rafael Jacob Stark
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
317ac6ea-e6de-31fb-0372-86e7c24c10d4