Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2009-02-20
- Stop
- 2009-02-20
The parties
- Patient
- patient Ja Lori Gottlieb
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
39a9f648-9e90-e24a-7704-15b55d9e9dbf