Claim total
$93.39
base $93.39 · payer covered $56.03
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2026-04-28
- Stop
- 2026-04-28
The parties
- Patient
- patient Beverley Kattie Keebler
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
0cb24d24-cb62-5e83-2eff-2491151990bb