Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2014-01-17
- Stop
- 2014-01-17
The parties
- Patient
- patient Cory Irwin Bergnaum
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
0a80947b-a6e7-a756-0468-227e5fdb1e18