Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1997-11-12
- Stop
- 1997-11-12
The parties
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
193e4bb3-7266-1ac6-ffa3-f10ef684ab1d