Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2020-06-05
- Stop
- 2020-06-05
The parties
- Patient
- patient Marc Ricky Gleason
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3876a6d0-4d16-b874-ad75-a2fb29d26d6b