Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2017-01-04
- Stop
- 2017-01-04
The parties
- Patient
- patient Jamey Korey Ullrich
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
18208ada-8c38-708d-ed08-e34c9a9e95f1