Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2022-11-24
- Stop
- 2022-11-24
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
050746ba-be7e-c592-dd30-5f55cc244954