Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-28
- Stop
- 2014-03-28
The parties
- Patient
- patient Brooks Fred Jones
- Provider
- provider Leta Sipes
- Payer
- payer Medicare
Record id
1b22a3c2-c430-b888-4c59-2e35339f9509