Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2013-06-16
- Stop
- 2013-06-16
The parties
- Patient
- patient Krista Jenniffer Kautzer
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
0f6846d9-5866-3324-0ec0-fdd6f647c63b