Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2016-08-30
- Stop
- 2016-08-30
The parties
- Patient
- patient Scotty Thomas Ratke
- Provider
- provider Madalyn Konopelski
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Anthem
Record id
2f3b1f3f-a4ca-67c8-9c9b-1a574d61a9d4