Claim total
$5,686.54
base $127.17 · payer covered $5,651.54
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2022-08-13
- Stop
- 2022-08-15
The parties
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
28dc95ea-454e-cf3c-c030-2c058a6304d5