Claim total
$4,087.70
base $127.17 · payer covered $4,087.70
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2025-03-01
- Stop
- 2025-03-03
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-e5e6-7d01f38f4c06