Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-25
- Stop
- 2014-03-25
The parties
- Patient
- patient Sacha Sharita Hodkiewicz
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
3428133e-e709-f6fe-033b-916d2e7204a7