Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2012-09-11
- Stop
- 2012-09-11
The parties
- Patient
- patient Devin Linnea Lowe
- Provider
- provider Rudolf Wolff
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2f0eca3c-3bd2-7c3b-6a09-bd91c291163f