Claim total
$13,355.56
base $155.66 · payer covered $13,320.56
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-12-16
- Stop
- 2017-12-16
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00decd7e-554a-447f-8e3f-0d4a318ce170