Claim total
$219.95
base $93.39 · payer covered $184.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2022-07-12
- Stop
- 2022-07-12
The parties
- Provider
- provider Michael Dibbert
- Payer
- payer Dual Eligible
Record id
04481159-34f8-6925-eb26-b37b65778c37