Claim total
$93.39
base $93.39 · payer covered $10.87
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2013-06-23
- Stop
- 2013-06-23
The parties
- Patient
- patient Joetta Antonette Bednar
- Provider
- provider Belkis Blick
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
2cb8de01-f198-8fe9-921a-72f371ff65bb