Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-07-23
- Stop
- 2024-07-23
The parties
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
04481159-34f8-6925-2c9b-50bb74d17b00