Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-18
- Stop
- 2014-03-18
The parties
- Patient
- patient Carmen Ramona Fonseca
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
2cc6efe0-8e4a-8ccd-333c-bd832ba401f5