Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2017-11-16
- Stop
- 2017-11-16
The parties
- Patient
- patient Rodger Leonardo Padberg
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
2beb7299-0f83-f346-a3cc-79ce9cd63071