Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-28
- Stop
- 2014-03-28
The parties
- Patient
- patient Gus Clair Nitzsche
- Provider
- provider Jo Stiedemann
- Payer
- payer Dual Eligible
Record id
105ade21-1b58-baca-0214-4ea36d2fcfa4