Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-06
- Stop
- 2014-04-06
The parties
- Patient
- patient Hans Austin Skiles
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
2a801a9c-9341-ed04-4c37-5e68cc4ce92a