Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2016-11-04
- Stop
- 2016-11-04
The parties
- Patient
- patient Adam Alfonzo Stokes
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
056ed411-c295-a5c9-188a-8e4bda2d18a2