Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-16
- Stop
- 2014-05-16
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Leta Sipes
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-687e-6e608f6bbab7