Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-03
- Stop
- 2014-04-03
The parties
- Patient
- patient Elia Felicia Mueller
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2a6e0e9c-1e79-6845-79ee-b09ad08133af