Claim total
$778.06
base $93.39 · payer covered $743.06
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2019-12-19
- Stop
- 2019-12-19
The parties
- Patient
- patient Terrell Allan Walter
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
0c1ee120-1dc7-6b68-ce8c-c6d0993240be