Claim total
$693.64
base $93.39 · payer covered $658.64
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-11-09
- Stop
- 2017-11-09
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-5d42-5b9936945689