Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2019-03-01
- Stop
- 2019-03-01
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
056f2732-3438-a432-63a2-545cb0a716bc