Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2002-04-12
- Stop
- 2002-04-12
The parties
- Patient
- patient Gus Clair Nitzsche
- Provider
- provider Leta Sipes
- Payer
- payer Medicare
Record id
105ade21-1b58-baca-4122-9d2346b6b85b