Claim total
$75.00
base $75.00 · payer covered $25.00
The visit
- Class
- Virtual
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2025-05-09
- Stop
- 2025-05-09
The parties
- Patient
- patient Craig Olin Cassin
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
255f4784-1651-1fb2-4e29-ce1b3e599c9c