Claim total
$11,929.75
base $155.66 · payer covered $3,501.45
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-10-04
- Stop
- 2025-10-05
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-5ec0-3f09621dd334