Claim total
$754.64
base $93.39 · payer covered $754.64
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2024-09-02
- Stop
- 2024-09-02
The parties
- Patient
- patient Boyce Jerrold Johns
- Provider
- provider Lilia Montañez
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
18cbb615-420a-8641-66f6-fb6bd722aa9c