Claim total
$9,299.76
base $127.17 · payer covered $7,439.68
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2015-01-18
- Stop
- 2015-01-23
The parties
- Patient
- patient Raylene Edris Parisian
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
298344b3-dd31-0e7f-4502-0e260f25347e