Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2024-06-09
- Stop
- 2024-06-09
The parties
- Patient
- patient Rayford Angel MacGyver
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
08664c97-8838-24c4-367c-2a1687fabe98