Claim total
$575.28
base $93.39 · payer covered $525.28
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-03-06
- Stop
- 2015-03-06
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-23ad-f451794d5706