Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2015-02-07
- Stop
- 2015-02-07
The parties
- Patient
- patient Tomas Josh Larson
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
2f6a8fd0-a41d-4cac-1f7c-6e5af5c5cbbf