Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1987-09-07
- Stop
- 1987-09-07
The parties
- Patient
- patient Darron Luigi Kuhlman
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
2ca6daed-ad8b-5612-9437-e36b3eba59ec