Claim total
$94.05
base $93.39 · payer covered $44.05
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2022-08-17
- Stop
- 2022-08-18
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-9262-58d6040b65a8