Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-30
- Stop
- 2014-03-30
The parties
- Patient
- patient Benito Delao
- Provider
- provider Jarvis Braun
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
30bb6e62-6649-f6c6-8ee1-bb9c34d3d902