Claim total
$1,754.82
base $93.39 · payer covered $1,403.85
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2015-12-29
- Stop
- 2015-12-29
The parties
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-aa22-1ec3508edb61