Claim total
$219.95
base $93.39 · payer covered $131.97
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2023-01-26
- Stop
- 2023-01-26
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Madalyn Konopelski
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0130f9d2-4df9-4b02-be98-fa4bef10893a