Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2014-04-02
- Stop
- 2014-04-02
The parties
- Patient
- patient Louie Petrina Ziemann
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
2db8ed08-2422-5c8b-957b-40a8a258e932