Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2001-12-13
- Stop
- 2001-12-13
The parties
- Patient
- patient Gwyn Andria Jakubowski
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
1d7176d6-ddf2-55da-0327-7bfed5f44a96