Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-25
- Stop
- 2014-03-25
The parties
- Patient
- patient Otis Jed Price
- Provider
- provider Ramiro Boehm
- Payer
- payer Dual Eligible
Record id
1d8b9eda-b86e-378b-c393-4b210faaaa73