Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2015-08-03
- Stop
- 2015-08-03
The parties
- Patient
- patient Assunta Ferry
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
3acf70ac-a702-cd75-0db2-3fc21588298b