Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 308335008
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2019-10-30
- Stop
- 2019-10-30
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-46e0-12beb05b8a1e