Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 1986-12-20
- Stop
- 1986-12-20
The parties
- Patient
- patient Leigha Sharleen Champlin
- Provider
- provider Ross Stehr
- Payer
- payer Medicaid
Record id
2f4e5dee-d991-4c97-a088-50e8550529ef