Claim total
$93.39
base $93.39 · payer covered $93.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-05
- Stop
- 2014-05-05
The parties
- Patient
- patient Elton Borer
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Aetna
Record id
0d0e1c95-f08c-7bc8-757e-18abf27a0059