Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2019-08-29
- Stop
- 2019-08-29
The parties
- Patient
- patient Ted Claude O'Conner
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
2ef29fe0-cf19-e6ae-7fc8-cfa2ff8ab6dd