Claim total
$75.00
base $75.00 · payer covered $0.00
The visit
- Class
- Virtual
- Code
- 185349003
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2020-12-28
- Stop
- 2020-12-28
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Cigna Health
Record id
03cbffbc-74a2-befb-952d-2c4ab3a1ccd9