Claim total
$219.95
base $93.39 · payer covered $219.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2018-03-17
- Stop
- 2018-03-17
The parties
- Patient
- patient Emery Herbert Steuber
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
003012ce-f819-e17b-a09e-9def3bbb876c