Claim total
$93.39
base $93.39 · payer covered $65.37
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2024-12-10
- Stop
- 2024-12-10
The parties
- Patient
- patient Domingo Jeff Prosacco
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
39eb5ea2-5667-6205-8ddb-69df44e05edb