Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2018-12-18
- Stop
- 2018-12-18
The parties
- Patient
- patient Cecil Smith
- Provider
- provider Criselda Bartell
- Payer
- payer Dual Eligible
Record id
29d86494-f39d-b250-10b1-4537af7cddcf