Claim total
$93.46
base $93.39 · payer covered $74.77
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2014-11-27
- Stop
- 2014-11-27
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
034c4f48-8c73-4f35-284a-92207086a9f0