Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2017-09-15
- Stop
- 2017-09-15
The parties
- Patient
- patient Lavinia Kera Bartoletti
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
268d0250-7a61-15d4-46fa-f3282806426d