Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-26
- Stop
- 2014-04-26
The parties
- Patient
- patient Matha Wanetta Greenholt
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
38475c93-5cdf-8ed5-bb85-c9e3359ca248