Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-01-31
- Stop
- 2014-01-31
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-7d50-0ba4cb7739cd