Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2007-06-19
- Stop
- 2007-06-19
The parties
- Patient
- patient Domenic Brock Dach
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
19137cbd-9649-bf65-8aef-d3f6539ebd5e