Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-30
- Stop
- 2014-03-30
The parties
- Patient
- patient Roman Romeo Nolan
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
104dd156-7eab-3c3d-e58b-124fecbf1c23