Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2018-11-01
- Stop
- 2018-11-01
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
050746ba-be7e-c592-4367-dde2901349c5