Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2006-12-14
- Stop
- 2006-12-14
The parties
- Patient
- patient Christy Lonnie Dare
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
07310d81-b798-6d62-acab-9fbcb788f6fa