Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-04
- Stop
- 2014-04-04
The parties
- Patient
- patient Allan Ivan Kuphal
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
2cc14d47-c00d-f33b-6599-2cdd1589c545