Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-07
- Stop
- 2014-04-07
The parties
- Patient
- patient Marvin Adrian Marquardt
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
33f3e96c-a0f1-4ae5-ca7c-df9598a0d2ce