Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-08
- Stop
- 2014-03-08
The parties
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
34ca1156-190d-d8c9-36bf-5866f9147418