Claim total
$11,857.28
base $127.17 · payer covered $11,807.28
The visit
- Class
- Inpatient
- Code
- 32485007
- Start
- 2025-01-08
- Stop
- 2025-01-09
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-b928-4e9aaaba739e