Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2013-07-05
- Stop
- 2013-07-05
The parties
- Patient
- patient Rosalind Gertude Olson
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
30209f9b-1d78-f7a0-eb44-80075919ec0d