Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-16
- Stop
- 2014-03-16
The parties
- Patient
- patient Jone Rae Hilpert
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
06668488-9bc5-0bda-ec3b-2da07cd045ab