Claim total
$1,097.93
base $93.39 · payer covered $1,047.93
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-03-01
- Stop
- 2024-03-01
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-3d8f-e3eb6dc3dc82