Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2018-01-06
- Stop
- 2018-01-06
The parties
- Patient
- patient Abe Adolph Berge
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
035310e6-92e0-05c1-c8bc-3b04736dcbe3