Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2011-08-12
- Stop
- 2011-08-12
The parties
- Patient
- patient Mallory Bobette Stehr
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
0ebd7f5a-eab8-697e-b682-7944a84e9f16