Claim total
$5,288.33
base $127.17 · payer covered $5,253.33
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2021-12-08
- Stop
- 2021-12-12
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-820f-b8556fe740d1