Claim total
$3,872.04
base $155.66 · payer covered $3,822.04
The visit
- Class
- Ambulatory
- Code
- 32485007
- Start
- 1999-11-22
- Stop
- 1999-11-22
The parties
- Patient
- patient Elbert Rod Lemke
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
039e51d1-c563-811d-eee6-48605e7697b8