Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2001-08-26
- Stop
- 2001-08-26
The parties
- Patient
- patient Sha Kohler
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
19dce853-ad87-d82e-b60c-f98d83a623bd