Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-01
- Stop
- 2014-05-01
The parties
- Patient
- patient Bambi Margareta Davis
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
157dfde4-08b5-f812-8281-63b063d05d36