Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2014-04-11
- Stop
- 2014-04-11
The parties
- Patient
- patient Sun Katie Cartwright
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
1c24f7dc-185e-7419-b74c-d538cb1f9cb5