Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-01
- Stop
- 2014-04-01
The parties
- Patient
- patient Freeman Winfred Erdman
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Aetna
Record id
17dd8403-c3e7-454f-2157-f77d978db334