Claim total
$75.00
base $75.00 · payer covered $25.00
The visit
- Class
- Virtual
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2025-06-04
- Stop
- 2025-06-04
The parties
- Patient
- patient Vernie Dolly Langworth
- Provider
- provider Clint Witting
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
11c9fe1a-7b8f-fc33-7378-e7b7914bf78d