Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-26
- Stop
- 2014-03-26
The parties
- Patient
- patient Joann Johnnie Brekke
- Provider
- provider Celesta Shields
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicaid
Record id
2f09e54c-8b86-6d4b-c4e6-646df2f2f74e