Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-02
- Stop
- 2014-04-02
The parties
- Patient
- patient Alton Patrick Dooley
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
3443265b-cbf5-d172-0b6b-67b0eaa6eeed