Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2013-11-15
- Stop
- 2013-11-15
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0400ef40-232f-be7a-813b-9f1c17cc89f9