Claim total
$8,828.86
base $155.66 · payer covered $8,828.86
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-06-15
- Stop
- 2018-06-15
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
031e24ca-9978-b353-8e85-4637e0996dfe