Claim total
$8,197.77
base $93.39 · payer covered $8,147.77
The visit
- Class
- Ambulatory
- Code
- 390906007
- Start
- 1999-11-07
- Stop
- 1999-11-07
The parties
- Patient
- patient Elbert Rod Lemke
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
039e51d1-c563-811d-a4d7-67a9c5f5c9d3