Claim total
$34,347.23
base $155.66 · payer covered $34,312.23
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-01-22
- Stop
- 2025-01-22
The parties
- Patient
- patient Tamesha Lecia Wyman
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
391bc040-899c-a7be-97a6-9a453de8ae7b