Claim total
$93.39
base $93.39 · payer covered $56.03
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-02
- Stop
- 2014-05-02
The parties
- Patient
- patient Leroy Javier Batz
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
2c19b131-403a-5087-bfcb-e8f9690c3980