Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-07-19
- Stop
- 2024-07-19
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-b0ef-3b060f5d5be1