Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1982-03-11
- Stop
- 1982-03-11
The parties
- Patient
- patient Orval Hershel Dietrich
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1a1f128e-0964-8a74-07d8-a6de9d80fe46