Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2007-07-25
- Stop
- 2007-07-25
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-8fd5-b696e5c4258b