Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-05
- Stop
- 2014-04-05
The parties
- Patient
- patient Shiloh Barbra Aufderhar
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
390fed25-ddad-3781-9684-70e1434a5939