Claim total
$93.39
base $93.39 · payer covered $65.37
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-22
- Stop
- 2014-03-22
The parties
- Patient
- patient Cierra Lucy Dietrich
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
1ef7ea10-bba3-6ea9-0b9f-8315b9fd6216