Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Major depressive disorder370143000
- Start
- 1992-04-09
- Stop
- 1992-04-09
The parties
- Patient
- patient Lacy Schumm
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1b98fd26-00a1-c39a-38ea-6aa0c38ad20b