Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-04-28
- Stop
- 2024-04-28
The parties
- Patient
- patient Isaac Vernon Marvin
- Provider
- provider Jarvis Braun
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
007e08f5-37d5-91e8-d94e-0099c6ac84b6