Claim total
$93.39
base $93.39 · payer covered $56.03
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2002-04-10
- Stop
- 2002-04-10
The parties
- Patient
- patient Delmer Maynard Kris
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
0b575b03-961f-f971-8c00-5c248694e456