Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2018-01-29
- Stop
- 2018-01-29
The parties
- Patient
- patient Laverne Stanley Osinski
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
1b725f0a-4f9d-132d-711e-ed2b24ee0d15