Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2000-08-09
- Stop
- 2000-08-09
The parties
- Patient
- patient Wilda Salley Aufderhar
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
132074e8-9d74-8f18-f4a1-ff8b400619f1