Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-27
- Stop
- 2014-03-27
The parties
- Patient
- patient Tod Carroll Deckow
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Cigna Health
Record id
08495056-b7fd-1e36-cfc2-2b7f36ee4c58