Claim total
$93.39
base $93.39 · payer covered $93.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-01-14
- Stop
- 2024-01-14
The parties
- Patient
- patient Trudy Olene Boyle
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
224e317b-5fe3-18df-77f1-c7cfc949ff2b