Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-23
- Stop
- 2014-03-23
The parties
- Patient
- patient Bob Sergio O'Hara
- Provider
- provider Kelvin Reichel
- Payer
- payer Dual Eligible
Record id
261c034c-cc44-5f0f-0aaf-86b45e7431db