Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-09-08
- Stop
- 2014-09-08
The parties
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
021142be-3a32-af72-1760-120d2029af09