Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-05
- Stop
- 2014-04-05
The parties
- Patient
- patient Jacqui Bess Baumbach
- Provider
- provider Jacquelyne Skiles
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
019cda32-2557-7f65-34a5-2c0d8575964f