Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Glycine max256355007
- Start
- 2003-10-11
- Stop
- 2003-10-11
The parties
- Patient
- patient Gilma Ivy Sporer
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
342f92f5-8a6e-b6a8-c3f2-4250915f12bf