Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-24
- Stop
- 2014-03-24
The parties
- Patient
- patient Ronald Harland Johns
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
32005ec4-5181-9332-105a-ffb9a4e4d26e