Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-12-10
- Stop
- 2024-12-10
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0277738c-b3e3-4ada-7234-8e22d438948e