Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2012-10-01
- Stop
- 2012-10-01
The parties
- Patient
- patient María Micaela Magaña
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
0b835039-e875-4ecd-49b3-ff7ce1e7116b