Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Primary fibromyalgia syndrome95417003
- Start
- 2014-10-01
- Stop
- 2014-10-01
The parties
- Patient
- patient Lelia Ariana Metz
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
28793fbe-ecef-a924-65d7-3a719cb9d165