Claim total
$566.96
base $155.66 · payer covered $460.35
The visit
- Class
- Ambulatory
- Code
- 308335008
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2023-03-26
- Stop
- 2023-03-26
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-1310-69dc53b5eba5