Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1992-05-02
- Stop
- 1992-05-02
The parties
- Patient
- patient Raven Julieta Johnson
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
1c0fdca8-d5a1-2af7-fa89-c17f17a55346