Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2017-10-15
- Stop
- 2017-10-15
The parties
- Patient
- patient Nadine Jennette Blanda
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
2fd4d5da-96ab-f21b-4c4c-57312cb24c14