Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-03
- Stop
- 2014-04-03
The parties
- Patient
- patient Darron Luigi Kuhlman
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
2ca6daed-ad8b-5612-d9ff-d0d558ec47c0