Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-29
- Stop
- 2014-03-29
The parties
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-a707-8705f3e154c7