Claim total
$1,800.28
base $93.39 · payer covered $1,750.28
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 2002-01-28
- Stop
- 2002-01-28
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05c57aa9-c3e8-2f04-0419-121686f8c3b1