Claim total
$75.00
base $75.00 · payer covered $40.00
The visit
- Class
- Virtual
- Code
- 390906007
- Reason
- diagnosis concept Hyperlipidemia55822004
- Start
- 2024-12-27
- Stop
- 2024-12-27
The parties
- Patient
- patient Vito Glenn Medhurst
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
26ddb759-380a-cffb-f4de-1f2ff2371486