Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2004-06-16
- Stop
- 2004-06-16
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Janice Huel
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-ffc8-5ffe66fbbe6f