Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-11-24
- Stop
- 2014-11-24
The parties
- Patient
- patient Marlana Loren Wiegand
- Provider
- provider Noe Hills
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0cc65fea-7da9-3528-db3c-17b584fdd68b