Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2025-02-26
- Stop
- 2025-02-26
The parties
- Patient
- patient Clinton Leonardo Kutch
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
32ade1b1-dacd-f29c-ca3f-2ee5571384ea