Claim total
$504.69
base $93.39 · payer covered $302.81
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2000-09-14
- Stop
- 2000-09-14
The parties
- Patient
- patient Erna Gayla Mayert
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
30cfe8d1-eb95-8f71-5582-8f2cc5d37d7b