Claim total
$566.96
base $155.66 · payer covered $118.60
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2023-10-07
- Stop
- 2023-10-07
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-3303-25cc8c1576a3