Claim total
$17,652.45
base $155.66 · payer covered $17,617.45
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-07-14
- Stop
- 2024-07-14
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-a035-b2de7558f6fd