Claim total
$264.89
base $93.39 · payer covered $214.89
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2018-11-15
- Stop
- 2018-11-15
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04658673-6112-6940-2456-7ccab23e7138