Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2004-07-09
- Stop
- 2004-07-09
The parties
- Patient
- patient Rufus Milford Koelpin
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
3a95383e-dcb8-456a-4f5c-9885265ad7ac