Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-29
- Stop
- 2014-03-29
The parties
- Patient
- patient Ashton Hisako Jaskolski
- Provider
- provider Kasi Schamberger
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2b9209bc-5607-5ae5-b281-6fc89a572086