Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1981-12-11
- Stop
- 1981-12-11
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
05c57aa9-c3e8-2f04-b426-3ee5e0f51f96