Claim total
$219.95
base $93.39 · payer covered $184.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2005-12-25
- Stop
- 2005-12-25
The parties
- Patient
- patient Sumiko Bethann Baumbach
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
23c570a1-24f2-7527-4f1e-0c626d3b3fce