Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2023-01-03
- Stop
- 2023-01-03
The parties
- Patient
- patient Lonna Shaina Lang
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
333a9dcf-5fad-a3e0-56dd-4bfc8ab93061