Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2017-08-09
- Stop
- 2017-08-09
The parties
- Patient
- patient Ramon Josef Hagenes
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
358aeebf-9459-7875-8cfe-1c50f4233071