Claim total
$93.39
base $93.39 · payer covered $93.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2023-01-28
- Stop
- 2023-01-28
The parties
- Patient
- patient Leroy Donald Kuvalis
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
12ff2bdf-30d7-88b6-376b-87e777cbb132