Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2025-01-15
- Stop
- 2025-01-15
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider Eldon Conn
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-cae0-9f662032f03b