Claim total
$75.00
base $75.00 · payer covered $25.00
The visit
- Class
- Virtual
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2022-04-04
- Stop
- 2022-04-04
The parties
- Patient
- patient Alphonse Barry Becker
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
22a1d769-7746-56a3-1045-ab18ac5c4bbb