Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-26
- Stop
- 2014-03-26
The parties
- Patient
- patient Chia Jalisa Champlin
- Provider
- provider Corrina Paucek
- Payer
- payer Cigna Health
Record id
03f9d33d-12ca-f1a8-ddd0-2a7acdffa6cd