Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1965-08-01
- Stop
- 1965-08-01
The parties
- Patient
- patient Whitney Gonzalo Spinka
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicaid
Record id
3993c7c5-7c54-f876-90a9-cbb85ac4789e