Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-27
- Stop
- 2014-03-27
The parties
- Patient
- patient Sheldon Milan Koch
- Provider
- provider Noreen Hudson
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Anthem
Record id
28fc4489-6f3e-4157-db27-a5f1b09eb57f