Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2015-01-15
- Stop
- 2015-01-15
The parties
- Patient
- patient Felipe Dwain Keebler
- Provider
- provider Pasquale Grimes
- Payer
- payer Humana
Record id
02f04cf4-122a-e8d3-8549-e19142ab04a6