Claim total
$12,894.85
base $127.17 · payer covered $12,844.85
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 1987-02-12
- Stop
- 1987-02-13
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-2016-af73a4755533