Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2023-08-28
- Stop
- 2023-08-28
The parties
- Patient
- patient Teisha Lubowitz
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
374d3cdf-40c0-164e-9f56-68c3cff41c86