Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2011-05-23
- Stop
- 2011-05-23
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
016a1a5e-4450-7aaa-606b-65c18bc96a38