Claim total
$75.00
base $75.00 · payer covered $25.00
The visit
- Class
- Virtual
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-08-06
- Stop
- 2024-08-06
The parties
- Patient
- patient Chantell Portia Daniel
- Provider
- provider Laurence Mosciski
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
194e887f-bbea-2bd4-4e09-32f0596f46ca