Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Ambulatory
- Code
- 448337001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2021-12-16
- Stop
- 2021-12-16
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-bd1b-ae205c4a0993