Claim total
$1,681.60
base $155.66 · payer covered $1,631.60
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-04-17
- Stop
- 2023-04-17
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-db70-a099f19d64eb