Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2004-12-23
- Stop
- 2004-12-23
The parties
- Patient
- patient Donita Kasandra Crooks
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
277f7208-da9a-7c08-5404-0228e56ee76c