Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-26
- Stop
- 2014-03-26
The parties
- Patient
- patient Lupe Lorenzo Brekke
- Provider
- provider Adrienne Hills
- Payer
- payer Dual Eligible
Record id
1816a270-2239-ee33-bd17-e61a5a5cc963