Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-20
- Stop
- 2014-05-20
The parties
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-70af-252bc89514bc