Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2025-04-21
- Stop
- 2025-04-21
The parties
- Patient
- patient Clay Brandon Schuppe
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3310e903-3aa7-ca72-afa3-81441c04839a