Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2026-04-25
- Stop
- 2026-04-25
The parties
- Patient
- patient Waltraud Tromp
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
1461ae1d-c357-fb97-8fb2-a021d555d875