Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2019-04-17
- Stop
- 2019-04-17
The parties
- Patient
- patient Kallie Roxane Rodriguez
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
294b84dd-0309-41d1-1d99-1167fa9c4661