Claim total
$915.99
base $93.39 · payer covered $865.99
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Adolescent idiopathic scoliosis203646004
- Start
- 1990-07-06
- Stop
- 1990-07-06
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Sherrie Feeney
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-6a78-fba45bda2f3d