Claim total
$866.85
base $93.39 · payer covered $816.85
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2002-03-13
- Stop
- 2002-03-13
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0190d3b1-c50c-bf7b-566a-45a52e5929fe