Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2016-11-23
- Stop
- 2016-11-24
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-294f-b119c04e7179