Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2010-11-21
- Stop
- 2010-11-21
The parties
- Patient
- patient Roderick Lloyd Gottlieb
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1bef94fd-46c7-91d1-31bc-e3399134af6c