Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2007-03-28
- Stop
- 2007-03-28
The parties
- Patient
- patient Shaina Wolff
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
131b868f-c77f-95c7-fb51-fa08cafddee7