Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2018-04-13
- Stop
- 2018-04-13
The parties
- Patient
- patient Gregorio Emory Zieme
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
08c7e7ec-1b6d-3f07-35d7-206879aefd8e