Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-03-18
- Stop
- 2014-03-18
The parties
- Patient
- patient Bruce Oscar Rath
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
38d7b5e6-2762-29d7-ffd9-d78801786601