Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2009-12-25
- Stop
- 2009-12-25
The parties
- Patient
- patient Alphonse Ricky Bernhard
- Provider
- provider Andria Spinka
- Payer
- payer Medicare
Record id
2e3c3108-70f2-7f33-e17e-9ccaeb340e10