Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1998-11-12
- Stop
- 1998-11-12
The parties
- Patient
- patient Brock Josiah Gaylord
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
2d5d1e2a-d4d9-a177-402b-c057550104ec