Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2013-04-30
- Stop
- 2013-04-30
The parties
- Patient
- patient Augustine Tromp
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
06d2c16f-b04d-02ef-943e-e51bfb0ae3be