Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2026-02-06
- Stop
- 2026-02-06
The parties
- Patient
- patient Reyes Ryan
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
13221e8b-52e3-93de-b5b8-4a0983c562dd