Claim total
$9,911.49
base $155.66 · payer covered $9,861.49
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-02-12
- Stop
- 2025-02-12
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04658673-6112-6940-072f-60f1cb1442b6