Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-28
- Stop
- 2014-03-28
The parties
- Patient
- patient Serafina Dickinson
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0ad0bcc5-9e9c-9616-7f2b-c320a764d70d