Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1974-10-10
- Stop
- 1974-10-10
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Belkis Blick
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
195810b4-1136-614f-4f97-08736aa53932