Claim total
$566.96
base $155.66 · payer covered $531.96
The visit
- Class
- Ambulatory
- Code
- 170838006
- Reason
- Allergic disposition609328004
- Start
- 2025-12-25
- Stop
- 2025-12-25
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-0786-e2e8688b04e9