Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2022-08-19
- Stop
- 2022-08-19
The parties
- Patient
- patient Emma Daphne Gusikowski
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
135051de-1be9-22ef-473f-c78c992809ea