Claim total
$1,388.98
base $93.39 · payer covered $1,338.98
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 2024-12-23
- Stop
- 2024-12-23
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-6318-4d6f-db038e632b5a