Claim total
$219.95
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2026-02-19
- Stop
- 2026-02-19
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0130f9d2-4df9-4b02-5489-1ea4566b7095