Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2019-01-24
- Stop
- 2019-01-24
The parties
- Patient
- patient Lorenzo Ramiro Melgar
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
17370847-0ea5-3761-1134-652f3f385be9