Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2026-05-28
- Stop
- 2026-05-28
The parties
- Patient
- patient Latonya Marisa Welch
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
3316b1fd-ee41-7777-9f36-e511b558a718