Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-31
- Stop
- 2014-03-31
The parties
- Patient
- patient Myrtice Kathlene White
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
23fa6ca1-e37e-f9c8-29de-3b0174e7dbb2