Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Shellfish735029006
- Start
- 1982-02-16
- Stop
- 1982-02-16
The parties
- Patient
- patient Shauna Tabetha Terry
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2ad448d9-22da-e102-445f-d8c6e53aa09d