Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1994-04-04
- Stop
- 1994-04-04
The parties
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
04481159-34f8-6925-9347-2ca25eaade59