Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1992-02-19
- Stop
- 1992-02-19
The parties
- Patient
- patient Perla Roseanne Herzog
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
1e76911d-0c60-0943-0a07-afd1dff68d92