Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-07
- Stop
- 2014-03-07
The parties
- Patient
- patient Freddy Stewart Gorczany
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
22e9c711-e56d-c784-4e46-d5179735af1c