Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-28
- Stop
- 2014-05-28
The parties
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-58af-70feb19bfebd