Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2003-01-05
- Stop
- 2003-01-05
The parties
- Patient
- patient Lanell Larson
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2a98f89f-76a4-67f9-2a2a-1f90249a368e