Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2014-06-08
- Stop
- 2014-06-08
The parties
- Patient
- patient Kirk Ty Jacobs
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
1e3196f8-1036-fdb0-64e2-fb1239aaaed2