Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1989-08-28
- Stop
- 1989-08-28
The parties
- Patient
- patient Belva Sau Barrows
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1625e802-c261-3bac-1ec7-07ec3ed33f29