Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-22
- Stop
- 2014-03-22
The parties
- Patient
- patient Gus Krajcik
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
295755aa-ec3c-f3a6-f5c2-937c26fee7d1