Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 2024-12-18
- Stop
- 2024-12-18
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider Lilia Montañez
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-2354-a54d0ff6445d